📌 Protecting farmers, freeing the breeders!

(from the archives)

Suman Sahai discusses India's progressive legislation in the area of patents and protection for plant varieties.

One of the most controversial agreements that resulted from the Uruguay Round of trade talks (GATT, preceding WTO) is that relating to the granting of Intellectual Property Rights on biological materials through the Trade Related Intellectual Property Rights (TRIPS) system. Under TRIPS member nations are required to grant patents on microorganisms, non/biological and microbiological processes as well as effective IPR protection for plant varieties. TRIPS provides a choice for protecting plant varieties. Members may choose from patents or a sui generis system (particular to the nation) or a combination of the two.

Most developing countries including India have decided not to have patents for plant varieties and have instead chosen the sui generis option. The sui generis system (translating roughly into self generating) means any system a country decides on, provided it grants effective Plant Breeders Rights. TRIPS does not specify what kind of Breeders Rights and it does not say what else a member state can put in its law, apart from Breeders Rights. In short, TRIPS is a flexible system leaving a lot to the discretion of members. As a response to the TRIPS agreement, India has started enacting a series of domestic laws to implement the commitments it has made. The Protection of Plant Variety and Farmers, Rights Act, 2001, is the Indian sui generis legislation.

Hailed as a progressive, pro/developing country legislation, this law provides for well-defined Breeder’s Rights as well as strong and proactive Farmers Rights. Its intent is the establishment of an effective system for protection of plant varieties, the rights of farmers and plant breeders and to encourage the development of new varieties of plants. The Act recognises the necessity of protecting the rights of farmers in respect of their contribution made in conserving, improving and making available plant genetic resources for the development of new plant varieties. In addition, there are clauses to protect the rights of researchers as well as the public interest. The Indian legislation is the first in the world to grant formal rights to farmers in a way that their self-reliance is not jeopardized.

Breeders Rights On registration of a particular variety, the plant breeder has rights of commercialization for the registered variety either in his/her own person or through a designated person. These rights include the right to produce, sell, market, distribute, import or export a variety, in short, full control over formal marketing. Violation of the breeder’s right can be construed at several levels. It applies to the variety itself as also to its packaging. Infringement will be established if the packaging is the same or even similar, such that the package could appear to be that of the Breeder. Legally, a similar looking package will be considered “Passing Off” and so actionable. Any one other than the breeder can not use the registered name or denomination. The use of the same or similar name in any way, by action or even suggestion, will constitute a violation and will be punishable. Penalties are prescribed for applying false denomination and for selling varieties to which false denomination is applied .

The breeders rights have been strengthened to the extent that if there is mere suspicion of violation or infringement, the onus of proving innocence is placed on the alleged violator. This is somewhat excessive and needs to be toned down. The normal course in law is for the accuser to furnish proof for the accusation and so it must remain in this case too. Penalties can range from Rs. 50,000 to Rs. ten lakh as well as a jail term ranging from three months to two years, depending on the severity of the damage caused. If the violator is actually selling , offering for sale or merely in the possession of a registered variety belonging to someone else, the punishment is somewhat worse. Repeat-offenders face more severe sentencing and penalties.

Protecting breeder’s rights ensures that there is sufficient incentive for the seed industry to invest. At the same time, it is important to recognize that IPR (Intellectual Property Rights) protection alone does not necessarily deliver a successful product. To be bought, a particular variety must decisively provide an advantage. Otherwise, it will fool the farmers for a few seasons and then fail.

An IPR system in a country should not grant such strong rights to breeders that farmers suffer and their livelihoods are threatened. On the other hand, the breeders’ innovation should be rewarded so that they continue to breed useful varieties to benefit agricultural and food security.

Farmers Rights The Act recognises the farmer not just as a cultivator but also as a conserver of the agricultural gene pool and a breeder who has bred several successful varieties. There are provisions for such farmers’ varieties to be registered with the help of NGOs so that they are protected against being scavenged by formal sector breeders. The law allows the farmer to sell seed in the way he has always done, with the restriction that this seed can not be branded with the Breeder’s registered name. In this way, both farmers and breeders rights are protected. The breeder is rewarded for his innovation by having control of the commercial market place but without being able to threaten the farmers’ ability to independently engage in his livelihood, and supporting the livelihood of other farmers.

The pivotal importance of the farmer having the right to sell (not save, not exchange, but sell) seed has to be seen in the context of seed production in India. In India, the farming community is the largest seed producer, providing about 87% of the country’s annual requirement of over 60 lakh tons. If the farmer were to be denied the right to sell, it would not only result in a substantial loss of income for him but far more importantly, such a step would displace the farming community as the country’s major seed provider. Legal sanction for farmers rights keeps the farming community alive and well as viable competitors and an effective deterrent to the take over of the seed market by the corporate sector. Control over seed production is central to food security which is in the forefront of national security.

Apart from the right to sell non-branded seed of protected varieties, the rights of farmers and local communities are protected in other ways too. There are provisions for acknowledging the role of rural communities as contributors of landraces and farmer varieties in the breeding of new plant varieties . Breeders wanting to use farmers varieties for creating Essentially Derived Varieties (EDVs) can not do so without the express permission of the farmers involved in the conservation of such varieties. Any one is entitled to register a community’s claim and have it duly recorded at a notified center. This intervention enables the registration of farmer varieties even if the farmers themselves cannot do this due to illiteracy or lack of awareness. If the claim on behalf of the community is found to be genuine, a procedure is initiated for benefit sharing so that a share of profits made from the use of a farmer variety in a new variety goes into a National Gene Fund.

Despite its good intentions of protecting the interests of the farming community, the formulation of this particular section is likely to create problems in implementation because the drafting is poor. The Gene Fund should be the recipient of all revenues payable to the farming community under various heads. Farming communities should collectively, rather than individually, access this money, except in clear cases where an identifiable farmer’s variety has been used. Farmers should have the right to decide how this money that they have earned will be spent. The use of the money should not be restricted to conservation or for maintaining ex situ collections.

The method for fixing and realising benefit sharing should be made simpler and easier to implement. One approach to fixing benefit sharing could be a system of lump-sum payments, based for example on (projected) volume of seed sale.

Protection Against Bad Seed In providing a liability clause in the section on Farmers Rights, the farmer in principle is protected against the supply of spurious and/ or poor quality seed leading to crop failures. But at present there is too much left to the discretion of the Plant Variety Authority which will fix the compensation. This could lead to arbitrary decisions and should be amended. (Sahai, 2001 a,b)

Rights Of Researchers All IPR systems must strike a balance between the monopoly granted to the IPR holder, in this case the plant breeder, and the benefits to society, in this case the farmers and consumers. Since nobody concerned with public interest would want plant breeding to shift into just a few hands, it is important to maintain competition and vitality in the plant breeding sector. That is why freedom and rights for other researchers to use all genetic material, including IPR protected material, is important. The Bill has provisions for researchers rights which allows scientists and breeders to have free access to registered varieties for research. The registered variety can also be used for the purpose of creating other, new varieties. The breeder can not stop other breeders from using his/her variety to breed new crop varieties except when the registered variety needs to be used repeatedly as a parental line. In that case authorisation is required.

There is however some difference of opinion. Some view that the Indian law actually grants very restricted rights to researchers because of the acknowledgment of Essentially Derived Varieties, EDV. It is felt that all kinds of research will become subject to the breeders authorization if a protected variety is used for research. In the Indian Act, the Breeders authorization is needed for making EDVs.

Protection Of Public Interest The PPV legislation includes public interest clauses, like exclusion of certain varieties from protection and the grant of Compulsory Licensing. To secure public interest, certain varieties may not be registered if it is felt that prevention of commercial exploitation of such variety is necessary to “protect order or public morality or human, animal and plant life and health or to avoid serious prejudice to the environment”.

The Act also provides for the granting of compulsory license to a party other than the holder of the Breeders certificate if it is shown that the reasonable requirements for seeds have not been satisfied or that the seed of the variety is not available to the public at a reasonable price. The breeder is entitled to file an opposition but should the charge be valid, the breeder may be ordered by the Authority to grant a compulsory license under certain terms and conditions including the payment of a reasonable license fee. Compulsory License however will not be awarded if the Breeder can demonstrate reasonable grounds for his inability to produce the seed.

This article is adapted from Suman Sahai, (2003) India’s Plant Variety Protection and Farmers’ Rights Act, 2001, Current Science.

This article appeared in India Together on 01 May 2003 - https://indiatogether.org/ppvlaw-agriculture/

📌 Did India win or lose at Cancun?

(from the archives)

Bilateral deals will be harder to resist; India must strengthen the home front as well as regional partnerships, says Suman Sahai.

The fifth ministerial meeting of the WTO was held at the beach resort city of Cancun in Mexico. It started amidst controversy on 10 September and ended with a whimper on Sunday 14 September. Since its inception in 1995, all member states of the WTO hold minister level meetings every two years. The purpose is to review the progress of international trade, take stock of problems in implementation and try to find solutions. In actual fact, every ministerial meeting since the first one in 1995, have been used by the block of developed countries to further their trade interests, at the cost of the interests of developing countries. Developing countries, unable to resist the bullying of the developed countries in the first years, have now started rallying round and are becoming more articulate in projecting their interests.

From the Indian point of view, the second ministerial meeting held in Singapore in 1997 was particularly disastrous Our negotiating team was ill informed about the issues, there was no consultation with experts, so positions were not well developed and there was no clarity even on what Indian interests actually were. The Indian government team lost a lot of ground and successive efforts were devoted to undoing some of this damage. The Indian situation was only a little better at the third ministerial held at Seattle in 1999 but we were saved by the defiant action of African nations. Fed up with the high handed and condescending attitude of the western nations, the Africans staged a walk out and caused the Seattle Ministerial meeting to derail completely. This process was helped by the internal politics of the US, which was facing a general election. The US preferred to see the meeting collapse rather than have to make concessions to the developing world that would have made the incumbent government unpopular at home.

The Doha Declaration was the first time that at least some developing country concerns were acknowledged. A timetable for implementation was framed; now that will not be met.

Developing countries gained a foothold in the international trade negotiations two years later, in Doha. Here too, it was the African nations that were the key factor. On the one hand was the raging HIV/ AIDS epidemic in Africa, on the other, the refusal of the pharmaceutical multinational companies to supply cheap AIDS medication. The refusal of the large drug companies to allow other manufacturers, like those in India, to supply cheap AIDS medicines was the last straw that broke the back of public opinion. Public outrage orchestrated successfully by civil society groups led to concessions on implementing patent provisions under TRIPS when it came to addressing public health needs. Even as US companies objected in order to protect their patent and market interests, which would be hurt if another country were able to supply cheap AIDS medicines, a pro-poor declaration was made.

The 2001 Doha Declaration was the first time that at least some developing country concerns with respect to public health, biodiversity and indigenous knowledge were acknowledged. A timetable for implementation was framed that will not be met and it is now clear that the developed countries will drag their feet in taking on board the developing country concerns that find mention in the Doha declaration.

The encouraging thing at Cancun was that India went to the meeting better prepared than to any other ministerial meeting. India’s principal stand at the Cancun meet was to demand the dismantling of the heavy agricultural subsidies granted by the EU and the US to their farmers and hence seek market access for its own agricultural produce in their markets. The second most visible focus of the Indian position was the determination not to allow the Singapore issues to become part of future negotiating agenda. In the Singapore issues, India’s main objections were to allowing a multilateral deal on competition and on foreign investment. This has been an old Indian position. The determination to negotiate aggressively on agriculture was at least partly dictated by the impending general elections in 2004 and the knowledge that granting any concessions that would affect farmers at home would be suicidal for a government seeking re-election.

At Cancun the talks broke down when Kenya, the leader of the Africa Group, walked out of the Minister level Green Room discussion. This was partly because of their vehement opposition to inclusion of the Singapore issues. The main reason however was the obduracy of the US against granting any concessions in agriculture, especially cutting back the heavy cotton subsidies that hurt cotton farmers in Africa. Once Kenya walked out, the Mexican chairperson closed the meeting and the Cancun talks collapsed.

For developing countries, multilateral platforms are more benign than bilateral deals where the bargaining can be harsh and the pressure of the dominant partner more intense.

This development is being greeted at home as a victory. But is it one? True, India emerged out of the shadows to once again become an important player on the global trading platform. True, the developing countries led by India, Brazil and China came together to defend their interests and this developing country solidarity was welcome since it is so seldom in evidence at the WTO. India’s Commerce Minister emerged as an articulate and conciliatory world leader, bringing credit to his country, but his contribution would have been many times greater had he come home with a deal rather than without one.

The breakdown at Cancun does not serve India’s interests, nor for that matter the interests of other developing countries. For developing countries, multilateral platforms are more benign than bilateral deals where the bargaining can be harsh and the pressure of the dominant partner more intense. The pressures on the major players like the US and EU is far more intense at the WTO than it can ever be in a bilateral negotiation. Under intense global scrutiny (and cast as the bullies in any case), the US and EU are much more motivated to appear as ‘fair traders’ sensitive to developing country concerns instead of the aggressive and distinctly ‘unfair traders’ that they actually are. So it is easier for developing countries to gain concessions at the WTO than it is in bilateral negotiations.

The road ahead needs to be charted carefully. It must include at least three important steps: maintain a respectable rate of growth at home so that we increase our trading (and negotiating) capacity; work hard to cement the new developing country solidarity and maintain the momentum of a common interest through the next two years, till the next WTO Ministerial comes round. And finally, explore and develop regional trade interests. With China joining hands with India at Cancun and India having acquired at least an observer status in ASEAN, there should be a more deliberate pursuit of regional trading blocks. It would not be mistaken to prepare for the next WTO meeting by stepping up regional trade and strengthening regional partnerships.

This article appeared in India Together on 01 Sept 2003 - https://indiatogether.org/winlose-economy/

📌 Challenging broad spectrum patents!

(from the archives)

The European Patent Office at Munich recently ran into opposition to a broad spectrum patent granted on all GM soyabean varieties to a Monsanto owned company.

On 5th May, an international group of civil society organisations in Munich, Germany challenged a patent granted to Agracetus (now a Monsanto company). The patent is for a particle bombardment (biolistic) method of transforming soybeans and importantly it was granted to cover all soybean varieties by the European Patent Office. This is a very broad spectrum patent awarded on all existing GM soybean varieties (and all other plants using the same GM technology used by the soyabean work). Greenpeace-Germany is coordinating this challenge.

Dr. Suman Sahai, president of the Delhi based non-government organization Gene Campaign was invited to Munich to depose as an expert to challenge the soybean patent before the Opposition Bench. The bench is a group of experts from the European Patent Office who sit to hear oppositions to a patent and decide on it. Others in the opposition coalition were Greenpeace Germany and civil society organizations from Canada, Germany as well as a scientific community member from China.

Interestingly, joining cause in opposition to this patent were the corporations Syngenta and De Kalb in Munich. Syngenta and De Kalb are in opposition because such a broad patent prevents them from entering the market with soyabean varieties of their own. They are obviously reluctant to accept that Monsanto will hold a monopoly on all GM soy varieties. Not surprisingly, before acquiring Agracetus Monsanto had opposed this patent. What is surprising though is the soy patent has been upheld in the EU which has so far had more liberal patent laws and greater reservations about plant patents. The grant seems to indicate an apparent shift in official EU policy. Ironically, a similar broad spectrum patent held by Agracetus on all GM cotton varieties, was struck down in the US.

A public meeting was organized by Greenpeace-Germany on May 6, to explain the negative consequences of such sweeping patents on the researchers and farmers of developing countries. Dr. Sahai said it is important to bring the attention of the west to the grave implications of such patent mediated monopolies on the food and livelihood security of developing countries since access to new technologies will be denied. In her deposition before the European Patent Office in Munich, Germany, Dr. Sahai argued for the canceling of the patent granted to Agracetus for transforming soybeans, covering all soybean varieties.

The philosophy and rationale of the patent system, which was to balance public and private interest. Now, with broad patents, monopolies are sought to be established in a way that private interest outstrips the public interest.

While some of the reasons cited for opposing the patent were technical, there were several arguments submitted that generic and question the very premise of granting any broad spectrum patent, soyabean included. According to those opposing this patent, if upheld it would effectively restrict access to this technology for anyone with new or novel ideas to further improve soybean. Any further research on soybean by any person or agency, without royalty payments to Agracetus would not be possible. This would create a situation that establishes monopoly, is anti-competitive and will stifle innovation and development in the field of agricultural research and crop development. In the present day of functional genomics, with its potential to discover new and novel genes that can be used for crop improvement, this broad spectrum patent will deter research to improve soybeans and other plants.

The impact of such a broad patent extending to all plants will become a grave impediment to the ability of developing country researchers to access new crop improvement technologies to breed new crops for their regions. Patents per se and such broad patents particularly have grave implications for farmers in developing countries. Restricting access to seed can strike at food and livelihood security by limiting the ability to access new seeds that can help to cope with biotic and abiotic stress situations that occur from time to time in agriculture. Patents of the kind being claimed and granted on biological materials and seeds are in essence faulty and cannot be defended since variability is a central feature of biology and the innovation is not reproducible. Every plant in a field of any crop variety will be different to the others.

Any patent on crop varieties and certainly one with such a broad scope is in essence inequitable and unjust since it appropriates the several innovative contributions made by other parties, specially farmers, who have created the land races and farmer varieties on the basis of which further breeding takes place. If it took a hundred steps to create a new crop variety, it would be safe to assume that farming communities have contributed at least the first 80 to 90 steps and the scientists such as the ones claiming this patent have contributed the last few steps. They cannot be allowed to appropriate the innovations and contributions of farming communities and other scientists by claiming a patent and that too one with such broad application.

In acknowledgement of the deeply critical nature of vital sectors like food and medicine for the survival and well being of communities in today’s developing countries, patent laws have granted a special status to these sectors. IPR regimes have been soft and flexible so that monopolies in the form of strong and exclusive patents do not become serious barriers to communities who have vulnerabilities with respect to food and health security. Broad spectrum patents go directly against the philosophy and rationale of the patent system, which was to balance public and private interest. The innovator was rewarded with a temporary monopoly on the invented product so that he/ she continued to benefit society by inventing new and useful products. This was the reason for ‘utility’ being such an important feature of a patent claim. Now, with broad patents, monopolies are sought to be established in a way that private interest outstrips the public interest. This attitude cannot be in the larger interest of most people and this patent must be opposed on that ground alone.

Later this month, the Opposition Bench ruled to uphold Monsanto’s broad patent. While the official decision will come out later, the civil society coalition that opposed the patent will go into appeal.

This article appeared in India Together on 01 May 2003 - https://indiatogether.org/brodpatnt-agriculture/ 

📍GM, agriculture, and food security

(from the archives)

India's position is opaque, based on incomplete research, and unresponsive to public health and food security issues. Dr. Suman Sahai lists recommendations from a national symposium.

A two day national symposium on “Relevance of GM Technology to Indian Agriculture and Food Security was organised by Gene Campaign on Nov. 26 and 27, in Delhi, to celebrate its 10th Anniversary. The Multistakeholder symposium brought together speakers and participants from across the entire range of views held on the subject of GM crops. Speakers ranged from strong supporters of GM technology to those equally strongly opposed to it and those with measured views. Participants included scientists, academics, social scientists, farmers, members of parliament, lawyers and judges, representatives of government, including the regulating agencies, various policy makers, the National Academy of Agricultural Sciences (NAAS), the seed industry, food processing and retailing industries, environmentalists, consumer organisations, organic farmers (IFOAM) and civil society organisations.

The two-day event witnessed a series of high quality presentations and strong, focussed discussions. One thing that all speakers pointed out was the appalling state of the Regulatory Framework in India and the urgent need to change it. Members of the Genetic Engineering Approval Committee (GEAC), India’s apex regulatory body explained the process of regulation and in the face of vociferous demand, agreed to put more data on the GEAC website.

Members of the Genetic Engineering Approval Committee explained the process of regulation, and were met with vociferous demands for better information.

A series of recommendations emerged from the two-day consultations. These are being forwarded to the Government’s Task Force on Biotechnology, the GEAC, the Department of Biotechnology, the Minister of Science and Technology, the Indian Council of Agricultural Research and the Ministry of Agriculture, the Ministry of Environment as well as the Prime Minister’s Office.

Recommendations

1. A distinct law should be enacted to oversee Genetic Modification Technology and its implementation. This law must harmonise with other laws and national and international agreements.
2. A comprehensive biotechnology policy should be developed in consultation with all stakeholders.
3. A statutory National Bioethics Commission must be set up.
4. There should be a consultative and participatory process to prioritise crops and traits for genetic improvement through biotechnology with the goal of addressing the needs of small farmers and Indian agriculture.
5. Investment in public sector research should be increased and strengthened. Novel gene discovery in crops of relevance to India should get highest priority.
6. India must develop a policy for transgenic varieties of crops for which it is a Centre of Origin and Diversity. Commercial cultivation of GM rice should not be allowed until the nature of gene flow and its impact is understood.
7. The Herbicide Tolerance trait should be subject to rigorous cost and risk benefit analysis before being considered for adoption.
8. Alternatives to the GM approach must be carefully evaluated in each case before deciding on the GM route. A cost and risk benefit analysis must be conducted before deciding on a GM product.
9. Protocol for food safety tests must be vastly improved and mechanisms for long term monitoring of human health (post GM food release) be put in place.
10. Develop a stringent protocol to assess environmental and ecological impact.
11. There should be provisions for post-market surveillance and monitoring of GM products.
12. Have a policy to deal with bio terrorism urgently.
13. India must exercise caution in the IPR regime that it adopts. The current PPV-FR should be retained since it balances Breeders and Farmers? Rights.
14. A new statutory, independent National Biotechnology Regulatory Authority must be established.
15. Make GEAC more competent, transparent and accountable. Post data on research and development of GM crops and products on websites and local newspapers.
16. An annual review of all decisions on GM products must be presented to Parliament.
17. Conduct a scientifically sound study to assess attitudes and perceptions about GM technology among stakeholders in India.
18. Undertake a program of awareness about GM technology to educate the public.
19. Organize a series of public debates across the country to elicit the views of the people, to channel it into policy making. The government should fund this exercise.
20. There should be a moratorium on commercial cultivation of GM crops until the regulatory system is demonstrably improved. Research on GM crops, however, should continue.

This article appeared in India Together on 01 Dec 2003: https://indiatogether.org/gmconf-agriculture/

📍How India’s shrinking education, health budgets are betraying rural youth!

As thousands of government schools close and health funds stagnate, Centre prioritises building roads over uplifting people, crippling our demographic dividend

After the students’ protest against repeated leaks of exam papers, attention has now shifted to the abysmal state of education in India.

According to a recent report, some 94,000 government schools have been closed down over the past 10 years. This in a country where education, especially in rural areas, is pitifully inadequate, even non-existent in some places.

Not surprisingly, the inexplicable action of closing government schools has led to a substantial drop in overall school enrolment. A corresponding rise in private school numbers should not surprise anyone either.

Enrolment falls

Families in the lower income bracket, especially in villages, know education is their only chance to give their children a better future. The closure of government schools is a brutal setback. It places a heavier burden on low-income rural and marginalised communities who rely on affordable public schools in the neighbourhood.

The mid-day meal offered by government schools is a particularly crucial support for families by providing one hot, nutritious meal to children who really need it.

There is another factor in the case of primary schools. The longer walking distance to private schools, far from the neighbourhood, triggers higher school dropouts, especially for young children and girl students. This unfortunate development is accompanied by official statistics that should be alarming for a country that has such challenges in the education sector and where large numbers of children and young people are not able to access a decent education.

Budget priority

There is a reliable metric for assessing whether a sector has gained or lost importance in government policy. That metric is the budget allocated to it.

The share of education in the Union Budget has declined significantly over the past 12 years. This raises questions about the government’s priorities and the relative importance being given to education.

The Education Ministry’s share in the Union Budget fell from 4.6 per cent in 2013-14 to just 2.5 per cent in 2025-26. This means education gets approximately half the money today compared to what it got 12 years ago.

The budget cut indicates that despite education remaining a fundamental requirement for India’s social and economic development, its relative priority in government spending has declined.

Skill building

Linked to education is the government programme on skill building. Training to upgrade skills in different sectors was started in the form of the National Skill Development Corporation (NSDC) established around 2008. This was later given a higher focus in 2015 in the shape of the Skill India Mission and the National Skill Development Mission.

Despite the importance of skill building and the government’s emphasis on Skill India, the actual allocation to the Ministry of Skill Development and Entrepreneurship has remained bafflingly minuscule. It started in 2015 with an embarrassing 0.06 per cent of the annual budget and sank further to 0.05 per cent by the time we came to 2025-2026.

The much-touted Skill India Mission is languishing at a measly 0.05 per cent of the annual budget. How will our youth, especially rural youth, get any skills to get decent jobs, turn entrepreneurs, or become income generators?

Rural healthcare neglected

The healthcare situation is no beacon of hope either. Look at the teeming numbers of patients from rural India thronging the hospital corridors, standing in mile-long queues in cities like Delhi, Lucknow, Patna…any city really.

The reason: there is very poor healthcare available in villages. Primary Health Care Centres (PHCs) don’t have medicines and are severely under-staffed; district hospitals are better but seriously lacking in quality healthcare. The result is that everyone flocks to urban centres where medical care is available.

The fact is that access to healthcare in India is highly inequitable. Cities have all the benefits: world-class hospitals, medical specialists, and the latest medicines. Rural areas, on the other hand, have to deal with doctor shortages, inadequate facilities, and limited access to essential care.

Even in government hospitals, urban centres have more than twice the number of hospital beds compared to villages. Urban areas, in addition, have a massive density of private tertiary-care hospitals. Over 80 per cent of speciality-qualified doctors practice in major cities, leaving rural PHCs devoid of specialists like surgeons, cardiologists, orthopaedists or paediatricians. Medical services like advanced diagnostics, intensive care units (ICUs), and multi-speciality care remain predominantly urban too.

Burden of rural poor

Since quality medical care is almost exclusively urban-centric, rural people must travel long distances and incur high out-of-pocket expenses for major medical needs.

In this grossly unjust backdrop, let us examine the government’s budget allocation for healthcare. The health budget has remained largely stagnant over the years, fluctuating between 0.5 per cent and 1.9 per cent of the GDP. That’s a shame for a country with such large challenges in the health sector and such a large disease burden in rural areas.

The decline or stagnation in government spending on education and health is extremely worrying for the future of India’s youth. Our demographic dividend, which should have been the motor for the country’s growth, has been hamstrung in the absence of support and has become a demographic burden.

What comes next shows the almost dystopian nature of government spending.

Roads get priority

As education, skill training and health are treated as (very) poor cousins, the roads and highways sector gets substantial support. The share of the Ministry of Road Transport & Highways in the Union Budget has almost trebled over the past 12 years, rising to nearly 6 per cent of the total budget in 2021-22 and it hasn’t changed substantially after that.

Now, it can’t be anyone’s case that roads and highways must not be built. We all agree that better connectivity is a good thing. But not ahead of essential requirements like health and education.

Not supporting health and education is a gross injustice since it affects the poor disproportionately. It is also a clear violation of the rights of all citizens to get equal access to the state’s resources, which are the resources created by taxes paid by the public.

The article appeared in The Federal on 26 August 2026: https://thefederal.com/category/opinion/education-skills-healthcare-government-spending-india-budget-priorities-254686